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Biomedical subjects

L T Taquino

Publications and source records attributed to L T Taquino.

7 recordsLinked to original sources

Designing and delivering neonatal care in single rooms.

This article will outline the phases of the design process and describe the outcomes as related to a specific neonatal intensive care design project. The single-room concept allows for increased privacy and confidentiality, as well as decreased stress of family, staff, and especially patients. The improvement in family space facilitates improved opportunities for encouraging parent and sibling participation in care. Specific developmental and technological improvements have also been gained and are outlined throughout the article.

Health Facility Environment↗

Neonatal thermal care, part I: Survey of temperature probe practices.

PURPOSE: To determine nurses' practices regarding skin temperature probes. DESIGN: Data were collected using an anonymous questionnaire, which was returned by mail. Questionnaires were distributed by volunteer neonatal nurses. Items included frequency of probe change, position of probe, use of probes in skin and air servocontrolled incubators and radiant warmers, as well as demographic data. SAMPLE: Eighty-three neonatal nurses. RESULTS: Nurses reported that skin servocontrolled incubators are used widely, but generally only for infants less than 28 weeks gestational age; a high proportion of respondents reported using continuous monitoring of skin temperature in air servocontrol incubators. Although most nurses reported positioning infants to prevent their lying on the probe, 21 percent reported using the same probe site regardless of infant position. Routine changing of the probe cover was reported by a number of nurses. Practices were influenced by individual knowledge, beliefs, and experience as well as by unit protocols, which varied widely.

Attitude of Health Personnel↗

Neonatal thermal care, part II: Microbial growth under temperature probe covers.

PURPOSE: To determine if temperature probe covers contribute to nosocomial infections by providing an environment for skin microbe colonization. DESIGN: Descriptive, comparative design with infants randomized into two groups: foam probe cover and hydrogel probe cover. Skin cultures were obtained 72 hours after cover placement. Bacterial growth was quantified after 24 and 48 hours. Skin integrity was assessed using visual irritations scores (VIS) every 5 minutes for 30 minutes following cover removal. ANOVA and ANOVA-RM were used to compare amounts of microbes and VIS scores between groups. SAMPLE: Twenty-six medically stable infants, 29 to 34 weeks gestational age, less than 10 days postbirth, and in an incubator. MAIN OUTCOME VARIABLE: Microbial growth and VIS. RESULTS: There were no statistically significant differences in microbial growth and VIS scores between groups (p > .05). Clinical significance was noted in VIS scores. Infants who had foam covers had more sustained irritation scores.

Analysis of Variance↗

Neonatal thermal care, part III: The effect of infant position and temperature probe placement.

PURPOSE: Accurate management of infant temperature requires appropriate placement of temperature monitoring probes. Currently, there is a lack of consensus regarding placement of skin temperature probes and the effect on temperature monitoring of the infant's lying on the probe. The objective of this study was to compare abdomen and back skin temperatures when infants were positioned supine and prone. DESIGN: A quasi-experimental design was used to randomize infants to prone or supine position. Infant back, abdomen, and axillary temperatures were measured at one-minute intervals with small disposable thermocouples over a one-hour period. SAMPLE: Twenty-three infants, weight 820-2,400 gm, gestational age 27-37 weeks, postnatal age three to ten days. MAIN OUTCOME VARIABLE: Gradient between abdomen and back temperature. RESULTS: Both mean abdomen and mean back temperatures differed significantly by position (t-test, p = .003 and .028, respectively). Weight and postnatal age did not have an effect on the mean difference between abdomen and back temperature. Results indicate that probe placement and infant positioning are important factors altering measurement of skin temperature.

Abdomen↗

Promoting wound healing in the neonatal setting: process versus protocol.

The principles of wound healing have been studied and evaluated extensively in the animal and human adult models. Practical application has been long in coming to the neonatal and critical care settings. Neonatal nurses have the ability to significantly affect the outcome of wound healing through the care they provide and the approaches that they take to caring for wounds. The article reviews pertinent literature to provide an evidence base for optimal wound care activities. An outcome-oriented, functional approach to product selection is described to help nurses meet the goals of protection, cleansing, moist wound healing, and appropriate dressing and care of wounds specific to the neonatal population.

Diaper Rash↗

Back to sleep: is there room in that crib for both AAP recommendations and developmentally supportive care?

This article offers one institution's approach to implementation of the recommendations for infant sleep positioning as set forth by the American Academy of Pediatrics. The guidelines are directed toward healthy infants in the first year of life, a population not always encountered by the neonatal nurse. The guidelines focus on supine sleep position and the minimization of additional bedding, both of which can be challenging when contrasted with accomplishing supportive positioning and the goals of developmentally supportive care for ill or preterm infants. A multidisciplinary task force was formed to consider this challenge. The outcome is an evidence-based policy that is presented as an example for other clinicians. The policy addresses the following major components: sleep position with specific clinical exceptions, the use of bedding materials, play position during awake states, and parent education with preparation for discharge. The article also outlines the process by which the task force plans to implement and evaluate necessary practice changes.

Beds↗

Caring for critically ill infants: strategies to promote physiological stability and improve developmental outcomes.

Promoting organization and delivering developmentally supportive care leads to improved outcomes for infants and their families. Critical care nurses must function as catalysts to expand the thinking of caregivers from a dimension consisting primarily of physiology to one that embraces the emotional and cognitive growth and well-being of the patient, the patient's family, and staff members. For critically ill infants, developmentally supportive care that is relationship based and that promotes the balance of organized neurobehavioral and physiological function is an avenue to achieve that end. Beneficial or adverse outcomes of nursing care used during this critical period can persist long after an infant is discharged from the intensive care setting.

Child Development↗